Modified Thoracoscopic Bullectomy / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Morbidity, the use of analgesics, the amount of postoperative drainage and the postoperative hospital stay were reduced in VATS for pneumothorax. However, some authors preferred minithoracotomy to VATS because the rate of recurrence after VATS were between 5% and 10%. Therefore, we present a modified thoracoscopic bullectomy (MTB) which we believe has the advantages of conventional VATS and minithoracotomy. MATERIAL AND METHOD: Sixty-six patients who received the operation from January 2002 to December 2002 were divided into 3 groups. Twenty-six patients were treated by axillary minithoracotomy and thirteen by conventional VATS and 18 by modified thoracoscopic bullectomy. The mean age was 21.9 years (range, 16~35 years) for minithoracotomy group, 20.6 years (range, 17~28 years) for conventional VATS group and 22.6 years (range, 16~39 years) for MTB group. The mean follow-ups were 11.4months for minithoracotomy group, 9.5 months for conventional VATS group and 4.7 months for MTB group. RESULT: The mean duration of operation was 55.79+/-23.35 minutes in MTB and 44.23+/-19.24 minutes in conventional VATS (p=0.333). The number of staplers being used was 1.63+/-0.76 in MTB, 1.41+/-0.64 in minithoracotomy (p=0.663), and 2.92+/-1.19 in conventional VATS (p<0.001). The duration of indwelling chest tube was 1.63+/-0.76 day in MTB, 4.07+/-1.41 day in minithoracotomy (p<0.001) and 4.46+/-2.33 day in conventional VATS (p<0.001). Hospital length of stay was 3.26+/-0.81 day in MTB, 6.04+/-2.21 day in minithoracotomy (p<0.001) and 6.69+/-3.33 day in conventional VATS (p<0.001). The number of postoperative complication and recurrence were 2 in minithoracotomy (7.4%), 5 in conventional VATS (38.5%) and 1 in MTB (5.6%). CONCLUSION: Modified thoracoscopic bullectomy is an effective procedure in the treatment of spontaneous pneumothorax.